A spike in the number of hand hygiene deficiencies cited in nursing homes is linked to inadequate staffing, new research reveals.

Between 2000 and 2002, nursing home inspectors issued hand hygiene deficiencies in fewer than 7.4% of facilities, but that number jumped to 12% by 2009.

Investigators said facilities with proportionately fewer RNs, LPNs and aides had significantly more deficiencies. States with lower Medicaid reimbursement rates also are more likely to have hand-washing lapses.

The study appeared in the Journal of Applied Gerontology.